Weight Loss Surgery - question about surgeries? Band v. Sleeve?




sindurella
08-09-2009, 05:49 PM
Hi everyone I am new here so forgive me if this has been answered and I missed it.

I am in the process to get the lap band surgery (getting cardio tests and blood work now) and haven't scheduled yet.

Here is my problem. I have been reading and reading online and have made contact with several people who have had the band and several years later had to have surgery to have band taken out and gone to the vertical sleeve.
Now I am questioning my decision to have the band and go with the sleeve.

Does anyone here have experience with this that can offer insight?

Confused
Lis


jiffypop
08-09-2009, 06:56 PM
we don't get too many people around here who've had the sleeve - but let's hope someone shows up!!!

jillybean720
08-09-2009, 08:58 PM
If it were me, I would go with the sleeve. The sleeve can't slip, won't erode your stomach, won't become detached, doesn't require fills/unfills, and doesn't create any unnaturally narrow passages in your digestive tract. And you don't have to mess with trying to find your "sweet spot" of restriction because you have the excess part of your stomach completely removed. AND with the removal of your excess stomach, they also remove the part that makes most of the ghrelin in your stomach, which is the hormone that often makes you feel hungry (ghrelin production will increase about 12-18 months after the VSG procedure, but it makes your first year or so easier to stick with to establish healthier habits).

All of that said, there is no long-term data on the VSG as a stand-alone procedure. There is some dismal 5-year data from the sleeve pushers in California (Dr.s Cirangle and Jossart), but they have excuses as to why it is so dismal, as more recent sleeves are made smaller than they used to be a few years ago. Due to the lack of long-term data, most insurances consider the VSG investigational/experimental and will not cover it (though you can fight through the appeals process and sometimes get it covered).

The VSG (just as the band) is considered best for those who are not SMO (i.e., BMI of less than 50). Those with higher BMIs will, of course, lose weight, but are not as likely to get as close to their goal weight. Of course, this is based on averages/statistics, and some people do beat the odds.

I have a VSG stomach as part of my procedure. I actually have a DS (well, sort of - long story), but the stomach of the DS is a VSG.


Leenie
08-09-2009, 09:43 PM
[COLOR=indigo]If it were me, I would go with the sleeve. The sleeve can't slip, won't erode your stomach, won't become detached, doesn't require fills/unfills,

These are things that can happen but don't happen to everyone... there are risks with any surgery.

MyGirlFriday
08-09-2009, 10:02 PM
Your insurance might cover the Lap Band but not the sleeve.....you might want to contact your insurance company to see which they cover.........then think about your options.

mgf~:flow1:

sindurella
08-09-2009, 10:48 PM
I think I am just going to call my doctor and start weighing my options with him again.

The more I read and hear I am thinking of going the malabsorbtion route. I have already been approved for the lap band so I don't know how hard it will be to change up the surgeries at this point

I am just trying to make the right decision for long term health, happiness, and quality of life.

preetyladyserenity
08-11-2009, 04:45 AM
Ok I can give some info.

I had the lap band a few years ago but mine was a failure because it eroded my stomach. My dad has the lap band with success for nearly 10 years (was one of the first people in my country). He has lost 70 kg and has maintained on his current weight for the last 5 years. He says he is happy with it.

Tommorow (lol) I am going to the government hospital to have the sleeve gastrectomy. I need to point here that in my country if you get approved to get a wls in the government hospital you get it for free. So I am not familiar with the insurance prceedures in the usa. Anyways the doctors here have started operating with the sleeve in the last three years so I got a quite some feedback from actual people that got the surgery.

a) Most say they have no eating problems and a few say they can't stomach meat anymore. 8 to 10 people I asked say they don't like staples anymore.

b) Craving for sweets is minimum after the surgery. People I asked told me that eating sugar makes them feel so bloated that they don't bother eating sweets anymore because it takes hours for them to get digested.

c) Most patients say the have no cravings for food and not this sound your tummy makes when hungry(I am not a native speaker of english I hope you know what I am talking about).

d) There is no vomiting.

e) Oily food is also avoided because it is not easily digested.

f) The thing is they have to go to the hospital every time they get a stomach ache just to eliminate any fear of the stomach getting a problem.

g) My boss' brother, who had the operation, told me that he never finishes his meals if he feels bloated because he is a bit scared of causing a problem.

By the way the wls programme I am joining includes sessions with an eating specialist so my portions will be given later on.

I can conduct you once I am better to give you more feedback on how the surgery went on. Oh and I have to point that in my place the government hospital only does the sleeve gastrectomy wls and thegastric bypass surgery. The doctors here stopped doing the lap band because it is considered an older option. One can have the lap band here in a private clinic but it is very expensive.

VeggieGal
08-11-2009, 02:29 PM
Sindurella, I had the sleeve done last year in May. I LOVE it! I could have gone with the RNY or the band, but an insurance snafu forced me to look for other options. I'm SO happy, because it wasn't til then that I heard about the VSG. I was self pay after all of the insurance mess, so I opted to go to Mexico. Best decision I've ever made. The surgery went without a hitch (laproscopic) and I feel perfectly normal. I don't really know what my "ideal" weight is, but I am 15# less than the goal I had in my head. I'm down 80#. The sleeve is purely restrictive, so that's how you lose weight...you eat less. I was freaked about rerouting of my intestines and once I learned about all the problems some people have with the band, the sleeve sounded perfect for me. I researched alot on obesityhelp.com in the Vertical Sleeve forum Best of luck to you :):)

sindurella
08-12-2009, 07:48 PM
thank you everyone for responding....

It has turned out that a good friend of a friend who I have met several times works for another hospitals WLS center. He actually works with me surgeon at that hospital.

Anyway I spent almost 3 hrs with him and got the skinny (ha) on everything I wanted to know. Without the the sell and bias of some people. So I have changed up from the lapband to the bypass. I think it will be better for me in the long run. I am thinking that I need more than just restriction and the malabsorb will be the thing that will help me most.

I have to say once I made the decision and I felt really comfortable and now more excited than ever to move forward. :)

Thanks again.
Lis

jillybean720
08-14-2009, 09:48 AM
thank you everyone for responding....

It has turned out that a good friend of a friend who I have met several times works for another hospitals WLS center. He actually works with me surgeon at that hospital.

Anyway I spent almost 3 hrs with him and got the skinny (ha) on everything I wanted to know. Without the the sell and bias of some people. So I have changed up from the lapband to the bypass. I think it will be better for me in the long run. I am thinking that I need more than just restriction and the malabsorb will be the thing that will help me most.

I have to say once I made the decision and I felt really comfortable and now more excited than ever to move forward. :)

Thanks again.
Lis
Have you researched the DS? Your friend may not know much about it since it's only done by about 30 surgeons in all of the US. You can check out www.dsfacts.com (http://www.dsfacts.com) for more info if you're interested.

sindurella
08-15-2009, 12:20 AM
I did look in to DS, but my insurance will not cover it. Also my surgeon does not do it also.

jillybean720
08-15-2009, 09:00 PM
I did look in to DS, but my insurance will not cover it. Also my surgeon does not do it also.
Both common problems. Changing surgeons is easy. If you have researched the DS and feel it may be the best option for you, I can direct you to multiple resources with expertise in getting insurance companies to cover the DS (especially in CA, as the CA external review board are very DS-friendly) - just let me know :)

jiffypop
08-16-2009, 05:03 PM
Sin - if you decide to go with DS -and it might be a great choice for you - just make sure you have access to the followup care you'll need - since DS isn't as commonly done as other surgeries, it's a little harder to find docs to keep up with your needs. and if your insurance company doesn't cover it - and you end up being self-pay [hope note!!!!], many insurers won't cover what they perceive to be complications from a not-covered surgery.

potentially ugly. and it's definitely not fair from a WLS perspective, but there it is!!!

ladyrider72472
08-16-2009, 08:04 PM
Sin.... I would research this site as well as others. I cannot remember the name of the person posting or the thread it was on--- but it was on this site.... and the sleeve was a huge failure. I know this happens with all WLS, but the lady posting was so desperate and swearing that she did what she was supposed to. She spent the money out of her pocket and now has no money and no WL (after a year). I don't mean to discourage you, but it really was a sad story..... and I believe she lost about 30K from it. Whatever you decide! Good Luck!

jillybean720
08-17-2009, 02:08 PM
Sin - if you decide to go with DS -and it might be a great choice for you - just make sure you have access to the followup care you'll need - since DS isn't as commonly done as other surgeries, it's a little harder to find docs to keep up with your needs. and if your insurance company doesn't cover it - and you end up being self-pay [hope note!!!!], many insurers won't cover what they perceive to be complications from a not-covered surgery.

potentially ugly. and it's definitely not fair from a WLS perspective, but there it is!!!
Unfortunately, there are a LOT of doctors out there who are not as well informed about WLS as we would like. But yes, since the DS is done in fewer locations, fewer doctors are familiar with it. I believe, to be a "good DSer," you really need to be proactive and stay on top of your health instead of relying on a doctor or dietician to always find the answers for you. Actually, I believe this to be true for ANY procedure.

Great example: I had my 3-month post-op labs done not too long ago. I had the results sent to both my surgeon's office and my PCP's office. Both also had copies of all my pre-op labs. I got notices from both offices that everything looked "fine" or "normal." Sounds great, right?

But when I sat down and compared my pre-op labs to these new 3-month results, I saw that my iron and ferritin levels had both dropped by more than half since my surgery and were now at the low end of the "normal" range, which means I was very quickly heading for iron-deficiency anemia. I started supplementing with iron right away and will see how my levels are at my 6-month labs and will adjust as needed (either the amount I'm taking or the type), but had I gone with what my doctors said, I likely would have been facing iron deficiency by 6 months post-op, which very likely would have required infusions to correct instead of just some supplements.

I see it all the time..."My labs are fine," or, "My labs are all normal." Okay, but how are your labs trending? We all need to step up and be a lot more involved in our own medical care post-WLS than we likely were before.

Okay, PSA over :p